Individual provider Active NPI

Spencer R Havens, MD

  • Physical Medicine & Rehabilitation Physician
  • Seattle, WA
National Provider Identifier
1902905037
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
ML20008236 Issued in WA
Practice address
1959 NE Pacific St
C-212, Box 356340
Seattle, WA 98195-6340
Phone
(206) 543-0065
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ML20008236 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
C-212, Box 356340
Seattle, WA 98195-6340

Mailing address

1959 NE Pacific St
C-212, Box 356340
Seattle, WA 98195-6340
Phone (206) 543-0065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130503000474 WA Order and Referring Only - Physical Medicine and RehabilitationPractitioner - Physical Medicine and Rehabilitation 9032356324

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ML20008236WAMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902905037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "address_2": "C-212, BOX 356340",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956340",
            "telephone_number": "206-543-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "address_2": "C-212, BOX 356340",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956340",
            "telephone_number": "206-543-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVENS",
        "first_name": "SPENCER",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "ML20008236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.